Efficacy of combined technetium-99m sulfur colloid/indium-111 leukocyte scans to detect infected total hip and knee arthroplasties

The reliability of combined indium-111 leukocyte/technetium-99m sulfur coll oid scans, with and without the addition of blood pooling and blood flow st udies, in the diagnosis of infected total joint arthroplasty was investigat ed. Both scans were performed on 58 patients before reoperation of total hi p or knee arthroplasty in the period 1996-1999. Results for imaging alone i ncluded 100% specificity, 46% sensitivity, 100% positive predictive value, 84% negative predictive value, and 88% accuracy. Inclusion of blood pooling and flow phase data improved results to 66% sensitivity, 89% negative pred ictive value, and 90% accuracy, with reductions in specificity (98%) and po sitive predictive value (91%). Routine use of these radionuclide scans is n ot supported by these data.